EVALUATION DE LA PRISE EN CHARGE DE L’HYPOSPADIAS AU SERVICE DE CHIRURGIE PEDIATRIQUE DU CHU ARISTIDE LE DANTEC DE DAKAR: A PROPOS DE 39 CAS

Abstract

Objective: To evaluate the outcomes of hypospadias surgery in our African context of practice. Patients and Methods: This is a retrospective study on 39 cases of hypospadias. This sample was collected over a period of 5 years from 1 June 2005 to May 31, 2010 at the department of paediatric surgery of Aristide Le Dantec Hospital in Dakar. Results: The average age of our patients was 4 years (6 months-14 years). Sixty nine percent of patients were older than 2 years. Hypospadias was anterior in 24 cases, middle in 13 cases and posterior in 2 cases. On the therapeutic level, all patients underwent a one stage repair. The surgical techniques most used were those of Mathieu (48.7%) and Duplay (23.1%). The stitches used for the urethroplasty was the PDS (5/0 to 7/0) in 10% of cases. The mean duration of urine drainage from the bladder was 4 days (3 and 7 days).The therapeutic results were considered good in 33.3% of cases, fair in 41% of cases and poor in 25.7% of cases. 53.8% of patients had complications, among those complications; urethro-cutaneous fistula was the most frequent with 57.1% of cases. Conclusion: The management of hypospadias in our working conditions is not yet satisfactory. Improving our results would be through improvement in technics and training of paediatric urologists involved in this type of surgery. Keys words: hypospadias children surgery results.